Intra-Abdominal Tumor in an Undescended Testis with Acute Abdominal Pain and Histopathological Features Suggestive of Alveolar Rhabdomyosarcoma: A Case Report
DOI:
https://doi.org/10.56127/jukeke.v5i2.2694Keywords:
Undescended Testis , Intra-Abdominal Tumor, Alveolar Rhabdomyosarcoma, Acute Abdominal Pain, Case ReportAbstract
Intra-abdominal tumors associated with undescended testis are rare and may present with nonspecific symptoms resembling acute abdominal conditions. In adults, untreated undescended testis can delay diagnosis because the affected testis is not located in the scrotum and may only become clinically evident after tumor enlargement or abdominal symptoms. Objective: This case report aims to describe an intra-abdominal tumor in a 27-year-old male with untreated undescended testis who presented with acute right lower abdominal pain and a mass in the right iliac region. Methodology: This study used a descriptive case report design. Data were collected retrospectively from patient history, physical examination, operative findings, macroscopic tissue documentation, and histopathological examination. The data were analyzed using a descriptive-narrative approach supported by relevant literature. Findings: The patient presented with persistent right lower abdominal pain, progressive abdominal mass, weight loss, decreased appetite, and a history of untreated undescended testis since birth. Physical examination revealed an asymmetrical scrotum, absence of the right testis in the scrotum and inguinal canal, and a solid immobile mass in the right iliac region. Orchidectomy was performed, and macroscopic examination showed a grayish-brown mass measuring 11 × 10 × 7 cm. Histopathological examination revealed a malignant lesion suggestive of alveolar rhabdomyosarcoma. Research Implications: This case emphasizes the importance of genital examination in male patients with unexplained acute abdominal pain. Intra-abdominal testicular or paratesticular tumors should be considered when an empty hemiscrotum or cryptorchidism history is present. Originality: This report presents an unusual case of untreated undescended testis associated with an intra-abdominal tumor and histopathological features suggestive of alveolar rhabdomyosarcoma.
References
Al Ghamdi, A. S., Alharbi, N. M., Miyajan, K. F., Hazzazi, A. A., Fadel, A. A., & Tabba, N. (2022). Alveolar paratesticular rhabdomyosarcoma in an adult patient mimicking epididymo-orchitis: A case report and a literature review. Cureus, 14(5), e24786. https://doi.org/10.7759/cureus.24786
Azorsa, D. O., Bode, P. K., Wachtel, M., Cheuk, A. T. C., Meltzer, P. S., Vokuhl, C., Camenisch, U., Khov, H. L., Bode, B., Schafer, B. W., & Khan, J. (2021). Immunohistochemical detection of PAX-FOXO1 fusion proteins in alveolar rhabdomyosarcoma using breakpoint specific monoclonal antibodies. Modern Pathology, 34(4), 748-757. https://doi.org/10.1038/s41379-020-00719-0
Banks, K., Tuazon, E., Berhane, K., Koh, C. J., De Filippo, R. E., Chang, A., Kim, S. S., Daneshmand, S., Davis-Dao, C., Lewinger, J. P., Bernstein, L., & Cortessis, V. K. (2013). Cryptorchidism and testicular germ cell tumors: Comprehensive meta-analysis reveals that association between these conditions diminished over time and is modified by clinical characteristics. Frontiers in Endocrinology, 3, 182. https://doi.org/10.3389/fendo.2012.00182
Chen, J., Liu, X., Lan, J., Li, T., She, C., Zhang, Q., & Yang, W. (2022). Rhabdomyosarcoma in adults: Case series and literature review. International Journal of Women's Health, 14, 405-414. https://doi.org/10.2147/IJWH.S352143
Ferguson, L., & Agoulnik, A. I. (2013). Testicular cancer and cryptorchidism. Frontiers in Endocrinology, 4, 32. https://doi.org/10.3389/fendo.2013.00032
Gonda, H., Saito, T., Osawa, T., Kurahashi, S., Matsumura, T., Fukami, Y., Komatsu, S., Kaneko, K., Hiramatsu, K., Kato, T., & Sano, T. (2021). Ruptured intra-abdominal testicular seminoma with hemorrhage shock, after inadequate surgical exploration for undescended testis: A case report. Surgical Case Reports, 7(1), 65. https://doi.org/10.1186/s40792-021-01143-5
Gupta, V., Giridhar, A., Sharma, R., Ahmed, S. M., Raju, K. V. V. N., & Rao, T. S. (2021). Malignancy in an undescended intra-abdominal testis: A single institution experience. Indian Journal of Surgical Oncology, 12(1), 133-138. https://doi.org/10.1007/s13193-020-01262-9
Ihssan, E., Salma, E., Ayoub, M., Amine, S., Zakia, B., & Kaoutar, Z. (2022). Primary intra-testicular rhabdomyosarcoma: Case report. International Journal of Surgery Case Reports, 96, 107340. https://doi.org/10.1016/j.ijscr.2022.107340
Liang, X., Wang, S., Li, T., Liu, L., Duan, Y., Luo, Y., Wang, Q., Hu, J., & Jiang, K. (2022). Alveolar rhabdomyosarcoma of epididymis: A case report. Frontiers in Oncology, 12, 1027504. https://doi.org/10.3389/fonc.2022.1027504
Lip, S. Z. L., Murchison, L. E. D., Cullis, P. S., Govan, L., & Carachi, R. (2013). A meta-analysis of the risk of boys with isolated cryptorchidism developing testicular cancer in later life. Archives of Disease in Childhood, 98(1), 20-26. https://doi.org/10.1136/archdischild-2012-302051
Mohamed, Y. G., Salad, N. M., Elmia, A. M., & Ali, A. M. (2022). Intra-abdominal mass with empty scrotum in adult male revealed as testicular seminoma: A case report. Radiology Case Reports, 17(9), 3308-3311. https://doi.org/10.1016/j.radcr.2022.06.038
Nkembe, M. N., Mvalo, C. M., Tianyi, F. L., & Demba, C. (2019). Ambiguous presentation of an intra-abdominal testicular seminoma in a 40-year-old man: A case report. Journal of Medical Case Reports, 13(1), 2. https://doi.org/10.1186/s13256-018-1917-3
Rajasimman, A. S., Sahoo, B., Alagappan, A., Das, P. K., Mishra, P., & Deep, N. (2022). Fistulous communication with bowel loop: A rare presentation of intra-abdominal seminoma. Egyptian Journal of Radiology and Nuclear Medicine, 53, 237. https://doi.org/10.1186/s43055-022-00921-x
Rourke, E., Digman, G., Gourley, E., & Kaushik, D. (2018). Large intra-abdominal seminoma in a left undescended testicle complicated by torsion. BMJ Case Reports, 2018, bcr-2017-222670. https://doi.org/10.1136/bcr-2017-222670
Yahaya, J. J., & Mremi, A. (2021). Primary intratesticular rhabdomyosarcoma in children: A case report and review of the literature. Journal of Medical Case Reports, 15(1), 37. https://doi.org/10.1186/s13256-020-02599-z
